Efficacy of pregabalin in the treatment of acute cerebral hemorrhage and its influence on prognosis

Introduction: Acute cerebral hemorrhage leads to high disability and mortality. Pregabalin, an α2δ1 subunit inhibitor, may reduce NMDA receptor-mediated neuronal injury and improve neurological outcomes. Methods: In this study, 158 patients with acute cerebral hemorrhage underwent minimally invasive hematoma evacuation and were assigned to receive either pregabalin or placebo for 2 weeks. Primary outcomes included hematoma volume, serum MMP2/MMP9 levels, neurological function (NIHSS), quality of life (ADL), and prognosis (GOS). Results: After 2 weeks of treatment, the pregabalin group showed significantly smaller hematoma volume compared with the control group (p < 0.01). Serum MMP2 and MMP9 levels were also significantly lower in the pregabalin group (both p < 0.01). At 12-week follow-up, patients receiving pregabalin demonstrated better neurological recovery (NIHSS, p < 0.01), improved quality of life (ADL, p < 0.01), and a higher proportion of favorable GOS outcomes (54.9% vs. 31.9%, p = 0.022). Conclusion: Pregabalin adjunct therapy significantly reduces hematoma volume, decreases MMP2/MMP9 levels, and improves neurological function and prognosis in patients with acute cerebral hemorrhage.